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Quantitative assessment of self-management in patients with nonalcoholic fatty liver disease: An unmet clinical need

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World Journal of Gastroenterology 2024年第25期30卷 3143-3146页

作者： Raffaele Borriello Giorgio Esposto Irene Mignini Antonio Gasbarrini Maria Assunta Zocco CEMAD Digestive Disease Center Fondazione Policlinico Universitario A.Gemelli IRCCSCatholic University of RomeRome 00168Italy

In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of Gastroenterology.Non-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and cirrhosis.The only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social support.While poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of follow-up.In this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase levels.The cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective communication.There is an urgent need for practical and effective instruments to assess the grade of self

关键词： Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Liver cirrhosis Metabolic associated fatty liver disease Metabolic associated steatohepatitis Insulin resistance self-management self-management measurement Patient education

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Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

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Journal of Integrative Nursing 2024年第2期6卷 127-135页

作者： Feyisayo Iyabo BAMIDELE Cecilia Bukola BELLO Oladayo Damilola AKINWALE Mubo Stella FALANA Department of Nursing Afe Babalola UniversityAdo‑EkitiEkiti StateNigeria Department of Nursing Redeemer’s UniversityEdeOsun StateNigeria

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

关键词： Health literacy intervention health-related quality of life people living with hypertension self-management

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Application Effect of WeChat Platform Continuity of Care Model Based on KAP Theory on self-management of Stroke Patients with Hypertension

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Journal of Clinical and Nursing Research 2024年第4期8卷 303-310页

作者： Qingjian Jiang Guangqiu Qin Li Zhang Guangxi University of Chinese Medicine Nanning 530000Guangxi ProvinceChina

Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharge from the hospital. Methods: 62 stroke patients with hypertension discharged from the rehabilitation department of a tertiary A hospital in Nanning City, Guangxi Zhuang Autonomous Region, from October 2022 to April 2023 were sampled by convenience sampling method. Patients discharged from Rehabilitation I were included in the control group, and conventional nursing care was used;while patients discharged from Rehabilitation II were included in the observation group, and WeChat platform continuity of nursing care model based on the KAP theory was implemented. The intervention effect of the two groups was compared. Results: After 4 and 12 weeks of intervention, the diastolic and systolic blood pressure of the patients in the observation group were lower than those in the control group (P self-management level of these patients.

关键词： WeChat platform Stroke Hypertension Continuity of care self-management

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Conceptual Analysis of self-management in Patients with Hypertension

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Journal of Clinical and Nursing Research 2024年第5期8卷 356-368页

作者： Li Yang Yutian Hao Liling Zhong Shilin Xu Saiqiong Zhong Yanying Lu Hui Liu The Fifth Affiliated Hospital Southern Medical UniversityGuangzhouGuangdong ProvinceChina Shenzhen Children’s Hospital ShenzhenGuangdong ProvinceChina The Guangzhou Red Cross Hospital GuangzhouGuangdong ProvinceChina The Second Affiliated Hospital of Shantou University Medical College ShantouGuangdong ProvinceChina

Objective:To clarify the concept of self-management in hypertensive patients by analyzing the definition,attributes,and measurement tools through a literature review.Methods:An Internet-based search of the databases was conducted using Academic Search Complete,Medical Line,CINAHL,Health Source:Nursing/Scholarly Edition,and Google Scholar.In the search process,keywords or free text were combined by using Boolean operators,with the search terms“self of management”or“self-management,”“concept*analysis”or“concept*definition,”and Walker and Avant’s concept analysis method was used.Results:Analysis of relevant literature summarized the conceptual attributes of self-management in hypertensive patients as the active participation of patients in the treatment process;the presence of interaction provided by patients and health care providers;the use of certain health management tools;and the aim of maintaining and improving the health status and living capacity of hypertensive patients.Conclusion:The concept of self-management for hypertensive patients was clarified,which helps to promote the application of hypertensive self-management in clinical work and improve outcomes and quality of life for patients with hypertension.

关键词： Hypertension self-management Concept analysis Walker and Avant’s concept analysis method

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Effect of Diabetes self-management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

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Journal of Biosciences and Medicines 2024年第3期12卷 316-327页

作者： Sahar Moawia Balla Elnour Tayseer Abdelmotalib Ahmed Taha Haiam Abdalla Wadatalla Ziryab Zainelabdin Mohamed Elmahdi Marwah Isam Abdulmajeed Mohammedahmed Rowa Abdelmonem Sidig Hamadto Nahla Yousif Osman Mohammed Saeed Omnia Mubarak Saad Abdallah Sulafa Abdelbagi Mustafa Ahmed Hanady Abdelhameed Ahmed Mohamed Sarah Khalil Fathi Khalil Family Medicine Health Gates Primary Care Riyadh SAU Family Medicine Dhaman Health Assurance Hospitals Company Kuwait KWT Family Medicine First Health Cluster Riyadh SAU Emergency Department Sheikh Khalifa Medical City Abudahbi ARE Family Medicine University of Medical Sciences and Technology Khartoum SDN Family Medicine Sudan Medical Specialization Board-Sudan Khartoum SDN Family Medicine Ultra Care Home Care Company Riyadh SAU Medicine Department Health Gates Primary Care Riyadh SAU Family Medicine Mouwasat Hospital Madinah SAU

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical r

关键词： Sudan Adherence Intervention Education self-management Diabetes

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What are the self-management experiences of the elderly with diabetes?A systematic review of qualitative research

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World Journal of Clinical Cases 2022年第4期10卷 1226-1241页

作者： Ting-Jun Li Jie Zhou Juan-Juan Ma Hui-Yan Luo Xiao-Mei Ye Department of Nursing The Second People's Hospital of Futian District ShenzhenShenzhen 518049Guangdong ProvinceChina Department of Nursing Shenzhen Shekou People’s HospitalShenzhen 518067Guangdong ProvinceChina Department of Traditional Chinese Medicine Shenzhen People's HospitalShenzhen 518000Guangdong ProvinceChina Intensive Care Unit The Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510220Guangdong ProvinceChina

BACKGROUND The number of elderly individuals with diabetes is dramatically increasing.Diabetes is a long-term condition and a noncommunicable disease and requires intensive daily self-management.Understanding of self-management from the patients’perspectives is important to nurses,healthcare providers,and researchers and benefits people by improving their self-management skills.AIM To examine and synthesize qualitative studies that explore the experiences of elderly people in self-managing diabetes.METHODS Electronic databases were searched,including MEDLINE,CINAH,PsycINFO,PubMed,CNKI,and WANFADATA.Relevant research was identified by manually searching reference lists and gray literature.Only English and Chinese publications were included.The Critical Appraisal Skills Program was used to assess the quality of the research.The Confidence in the Evidence from Reviews of Qualitative research approach was used to assess the confidence of the findings.RESULTS A total of 10 qualitative studies were included,and content analysis was performed.Five themes were identified:The need for knowledge about diabetes care,support systems,functional decline,attitudes toward diabetes,and healthy lifestyle challenges.CONCLUSION This present review provides a deep and broad understanding of the experiences in the self-management of diabetes and can be valuable to nursing practice and provide recommendations for future research.

关键词： The elderly self-management Diabetes Experience Systematic review

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Identifying behavioral determinants and stage of readiness for performing knee massage among individuals with knee osteoarthritis:An observational study

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Journal of Integrative Medicine 2024年第1期22卷 54-63页

作者： Donya Nemati Niki Munk Navin Kaushal College of Nursing the Ohio State UniversityColumbusOH 43210USA Department of Health Sciences School of Health&Human SciencesIndiana UniversityIndianapolisIN 46202USA National Centre for Naturopathic Medicine Southern Cross UniversityLismoreNew South Wales 2480Australia Australian Research Centre in Complementary and Integrative Medicine(ARCCIM) Massage&Myotherapy Australia Fellow and Visiting Faculty of HealthUniversity of Technology SydneyNew South Wales 2007Australia

Objective Patients who experience knee osteoarthritis or chronic knee pain can alleviate their symptoms by performing self-knee massage.Understanding the readiness and types of determinants needed to facilitate self-knee massage is needed to design effective,theory-informed interventions.The primary objective of this study was to apply the transtheoretical model of behavior change to identify how factors,which include the type of knee condition and pain level,predict an individual’s readiness to adopt self-knee massage.The secondary objective employed the capability,opportunity and motivation-behavior(COM-B)model to identify relevant determinants that are predictive of an individual’s readiness to undertake self-knee massage.Methods An observational study design was used to recruit individuals with knee osteoarthritis(n=270)and chronic knee pain(n=130).Participants completed an online survey that assessed the transtheoretical model of behavior change stages,COM-B determinants(capability,opportunity and motivation),along with self-administered massage behavior.Multivariate analysis of covariance and structural equation modeling were used to test the primary and secondary objective,respectively.Results Participants who had knee osteoarthritis scored higher on the action stage compared to those with chronic pain(P=0.003),and those who experienced greater level of pain scored higher in the contemplation(Pself-administered knee massage to be predicted by capability(β=0.31,P=0.004)and motivation(β=0.29,Pself-administered massage behavior(β=0.10,P=0.002).Conclusion Clinicians and researchers can expect that patient

关键词： Osteoarthritis Massage self-management Transtheoretical model of behavior change Behavioral model

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The analysis of the adherence of liver transplant recipients to immunosuppressant treatment, their self-control, and self-management in the post-transplantation period

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iLIVER 2023年第2期2卷 97-102页

作者： FadimeÇınar Semra Bulbuloglu Division of Surgical Nursing Nursing DepartmentFaculty of Health SciencesIstanbul Nisantasi UniversityIstanbul 34295Turkey Division of Surgical Nursing Nursing DepartmentFaculty of Health SciencesIstanbul Aydin UniversityIstanbul 34295Turkey

Background and amis:In our study,it was aimed to investigate the adherence of liver transplant recipients to immunosuppressant therapy,their self-control,and their self-management in the post-transplantation period.Methods:The sample of this descriptive and cross-sectional study was composed of liver transplant recipients.The personal information form,Immunosuppressant Therapy Adherence Scale,and the Liver self-Control and selfmanagement Scale were used to collect data,and descriptive statistical methods,independent samples t-test and one-way analysis of variance analysis was used to analyze the collected data.Results:In light of the data collected in this study,it was identified that,of all recipients,73.6%were 45–64 years old,72.5%were male,25.2%were workers,and 44.6%had equivalent income and expenses.It was observed that the recipients did not fully adhere to the immunosuppressant therapy regimen,and their self-control and selfmanagement levels were below the medium level.Conclusion:The social support system of liver transplant recipients is very important.Recipients with a good social support system can receive caregiver support from their relatives,thereby supporting their self-control and selfmanagement.Both liver transplant patients and the people providing care to them should be simultaneously provided with training programs and given information,and both groups should be supported in treatment and care processes.

关键词： Immunosuppressant therapy Liver transplant Post-transplantation period Recipients self-control self-management

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Impact of stage-specific limb function exercises guided by a selfmanagement education model on arteriovenous fistula maturation status

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World Journal of Clinical Cases 2024年第14期12卷 2316-2323页

作者： Yi Li Li-Jun Huang Jian-Wen Hou Dan-Dan Hu Department of Nursing The People's Hospital of Jianyang CityJianyang 641400Sichuan ProvinceChina Department of Nephrology The People's Hospital of Jianyang CityJianyang 641400Sichuan ProvinceChina Department of Head and Neck Surgery Zhejiang Cancer HospitalHangzhou 310000Zhejiang ProvinceChina School of Nursing Shangqiu Institute of TechnologyShangqiu 476005Henan ProvinceChina

BACKGROUND The exercise of limb function is the most economical and safe method to promote the maturation of arteriovenous fistula(AVF).However,due to the lack of a uni-fied exercise standard in China,many patients have insufficient awareness of the importance of AVF,leading to poor effectiveness of limb function exercise.The self-management education model can effectively promote patients to take pro-active health-related actions.This study focuses on the characteristics of patients during the peri-AVF period and conducts a phased limb function exercise under the guidance of the self-management education model to observe changes in fac-tors such as the maturity of AVF.AIM To assess the impact of stage-specific limb function exercises,directed by a self-management education model,on the maturation status of AVFs.METHODS This study is a randomized controlled trial involving 74 patients with forearm AVFs from the Nephrology Department of a tertiary hospital in Sichuan Province,China.Patients were randomly divided into an observation group and a control group using a random number table method.The observation group underwent tailored stage-specific limb func-tion exercises,informed by a self-management education model which took into account the unique features of AVF at various stages,in conjunction with routine care.Conversely,the control group was given standard limb function exercises along with routine care.The assessment involves the maturity of AVFs post-intervention,post-operative complications,and the self-management level of the fistula in both groups patients.Analyses were conducted using SPSS version 23.0.Count data were represented by frequency and percentage and subjected to chi-square test comparisons.Measurement data adhering to a normal distribution were presented as mean±SD.The independent samples t-test was utilized for inter-group comparisons,while the paired t-test was used for intra-group comparisons.For measurement data not fitting a normal distribution,the median and interquartile range were

关键词： self-management Education model Stage-specific Limb function exercises Arteriovenous fistula Maturation status

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self-management and self-efficacy status in liver recipients

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Hepatobiliary & Pancreatic Diseases International 2015年第3期14卷 253-262页

作者： Lei Xing Qin-Yun Chen Jia-Ning Li Zhi-Qiu Hu Ye Zhang Ran Tao Center for Organ Transplantation and Department of Surgery Ruijin Hospital Shanghai Jiaotong University School of Medicine Nursing School Shanghai Jiaotong University School of Medicine Department of General Surgery Central Hospital of Minhang District

BACKGROUND： Liver transplantation （LT） is a viable treatment for patients with end-stage chronic liver diseases. The main aim of LT is to prolong life and improve life quality. However, although survival after LT continues to improve, some aspects of recipient＇s health-related quality of life such as self-man- agement and self-efficacy have been largely ignored.

关键词： liver transplantation self-management self-efficacy quality of life questionnaires

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